Research Finds Bodybuilders With Similar Body Image Concerns, Whether or Not They Use Steroids

Jun 29, 2009

When it comes to characteristics associated with muscle dysmorphia, there is no difference between bodybuilders who use steroids and those who do not, a University of Arkansas researcher found.

Muscle dysmorphia is a disorder characterized by an individual’s excessive preoccupation with muscularity and body fat percentage, usually in bodybuilding. It is predominantly evident in males when there is a pathological preoccupation with a lack of muscular size and leanness.

Timothy Baghurst, a visiting assistant professor of kinesiology at the University of Arkansas, believes he had the disorder at one time in his life, which prompted his research in the area. Daniel Kissinger is a licensed professional counselor who helped shape and integrate the mental health elements of the study and discussion of muscle dysmorphia with Baghurst.

“One of the problems associated with classifying muscular dysmorphia is that, while it is receiving increasing attention in the mental health literature, muscle dysmorphia is not recognized by the American Psychological Association as a distinct mental illness,” said Kissinger.

However, “studies have linked muscle dysmorphia with diagnoses from several recognized diagnostic categories, including somatoform disorders, eating disorders and anxiety disorders,” he said. “Still, it is likely that the notion of muscle dysmorphia and its larger clinical implications remain unfamiliar to many mental health professionals.”

Baghurst also found that there is no agreement as to how muscle dysmorphia should be measured.

“Currently, there is no way to measure if a person has muscle dysmorphia,” Baghurst said. “Inventories measure only the degree of traits and characteristics associated with muscular dysmorphia.”

“With respect to muscle dysmorphia, there is no cut off to determine whether or not someone has it,” Baghurst said. “We have a continuum, where some people fall on the high end, some on the low end, but most fall in the middle.”

In his research, Baghurst made a distinction between bodybuilders that was not previously made. He divided bodybuilders into the sub-groups of “natural” and “non-natural.” Natural bodybuilding refers to competitions in which participants are drug-tested and must pass a polygraph regarding their lack of prohibited drug use. Non-natural bodybuilding refers to those competitions in which participants are not required to pass a polygraph, nor are they drug tested prior to competition.

Baghurst found that steroid use is not necessary to be heavily concerned with muscularity and leanness.

“Most people will assume bodybuilders using steroids are those with muscle dysmorphia,” he said. “By separating natural and non-natural bodybuilders, I found that either group is equally likely to have all of the traits of muscle dysmorphia with the exception of pharmacological use.”

Baghurst used the 27-question Muscle Dysmorphia Inventory to survey participants. The participants consisted of competitive natural and non-natural bodybuilders, non-competitive weight trainers who concentrate on improving physique and collegiate football players. The collegiate football players scored lowest on all subscales of muscle dysmorphia except for physique protection, where they scored highest. He found that collegiate football players do not appear to exhibit traits associated with muscle dysmorphia to the same degree as other weight-training groups.

Baghurst also found those males who were weight training to improve their physique, but were not bodybuilders also had some characteristics associated with muscle dysmorphia including dissatisfaction with their size and symmetry.

"This is an important finding, because it shows that someone doesn't have to be big and buff to have concerns about how muscular they are or how much body fat they have," Baghurst said.

The results of Baghurst’s research were published in the international journal Body Image in June 2009 and his review of previous studies of muscle dysmorphia was released in Volume 8 of the International Journal of Men’s Health of 2009.

Kissinger was the second author of the article in the International Journal of Men’s Health.

“Although this study was not aimed at mental health professionals specifically, the link between muscle dysmorphia and higher usage levels of laxatives, diuretics and steroids among non-natural bodybuilders has clear implications for mental health professionals,” he said.

The article was a “theoretical challenge for people to go further in the direction of muscle dysmorphia study,” Baghurst said.

Baghurst and Kissinger are both professors in the College of Education and Health Professions at the University of Arkansas. Baghurst is a visiting assistant professor in health science, kinesiology, recreation and dance. Kissinger is an assistant professor of counselor education in the department of rehabilitation, human resources and communication disorders.

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